Van Someren Group

Patients sleep badly in hospitals

First research on sleep in hospitals

On average, patients sleep nearly 1.5 hours shorter in a hospital than they do at home. They also wake up more often during the night and do not sleep in. In addition, inpatients also rate the quality of sleep in hospital lower than sleep at home. This has emerged from research among more than 2000 patients in 39 Dutch hospitals. The research was initiated by acute internists (ORCA research consortium) and coordinated by Amsterdam UMC, location VUmc, the Netherlands Institute for Neuroscience and Rijnstate Hospital. “It is time we pay more attention to this subject now we know how much poorer the sleep of hospital patients is” says one of the lead researchers, Prabath Nanayakkara (acute internist at location VUmc). The study was published today in JAMA Internal Medicine.

For this study, 2005 patients in 39 hospitals were approached with a questionnaire about their night’s sleep, both in hospital and at home. With this research, doctors wanted to learn more about the perceived sleep quality of patients and what needs to be changed to improve sleep in hospitals.

Quality of a night’s rest

The research shows that, on average, inpatients wake up almost 45 minutes earlier and in 70% of the cases this does not happen spontaneously. The quality of the night’s sleep is also rated lower than the sleep quality at home: patients wake up feeling more tired, restless, and they feel less rested. This could be due to their illness (nausea, pain, anxiety, etc.), but more often this is due to hospital-related factors (noise from fellow patients and staff, bright light in the hallway, uncomfortable beds, beeps from infusion systems, and toilet visits, possibly increased by being on a drip, or having been administered diuretics).

Physical and emotional stress

This research is important because a bad night’s sleep can stand in the way of recovery. Moreover, it makes patients vulnerable to physical and emotional stress. During a hospital stay, everything is usually done to ensure that patients recover as quickly as possible, but until now, little was known about the sleep quality of inpatients.

Based on these results, the advice to doctors and nurses is to focus more on optimizing sleep, with the above-mentioned sleep-disturbing factors that emerged from this study in mind. A follow-up study on how to improve the night’s rest in hospitals is currently being prepared.

Photo: Parentingupstream, Pixabay
Source: Amsterdam UMC, Location VUmc



Van Someren Group

Against the background of their 24-hour rhythm, driven by the circadian clock of the brain, sleep and wakefulness show a mutual dependency. The Sleep & Cognition group investigates how sleep affects brain function during subsequent wakefulness, and how experiences during wakefulness affect subsequent sleep. We aim firstly to elucidate factors that promote and disturb sleep at the systems level, notably insomnia, and secondly to investigate the brain mechanisms involved in the favorable and disruptive effects on cognition of, respectively, sleep and sleep disturbances. We think it’s important to translate fundamental insights into applications to improve sleep, vigilance and daytime function.

Human research tools include, in addition to the standard sleep-lab, brain imaging (high-density-EEG, MEG, fMRI on 1.5, 3 and soon 7 Tesla), transcranial magnetic stimulation (TMS), eye-tracking, computerized induction and assessment of task performance. The sleep-lab has a unique setup for comfortable skin temperature clamping in humans. An arsenal of ambulatory monitoring equipment is available. A web-based assessment tool for extensive insomnia and good sleep phenotyping has resulted in a growing database of, at present, 13000 people. The tool is available for other researchers that want to cooperate.

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